Senior Inpatient Utilization & Care Management Director

Kardow; Long Beach (CA); On-site; USD 102,000 - 198,000; Full time

Job summary

Molina Healthcare is seeking an experienced leader to oversee a multidisciplinary team delivering integrated care across care management, utilization management, LTSS, and behavioral health in California. The role requires CA licensure and extensive IPA delegation experience.

The position directs clinical programs, collaborates with senior leadership on strategic goals, and ensures adherence to regulatory requirements while maintaining cost-effective, quality member care.

Qualifications

• 8+ years health care experience with 5+ years in managed care.
• 3+ years health care management/leadership.
• Active CA licensure (RN/LVN/LPN) or related license where required.
• Experience with applicable regulations and compliance.
• Strong written and verbal communication skills.

Responsibilities

• Directs and oversees care management, utilization management, LTSS or behavioral health programs.
• Develops and enforces standardized protocols for care coordination and review.
• Promotes interdepartmental integration to enhance clinical services.
• Collaborates with senior leadership to address operational issues and resource needs.
• Facilitates committees and multidisciplinary teams to standardize enterprise care programs.
• Ensures monthly auditing with follow-up.
• Engages in clinical training activities and mentors staff.
• Local travel may be required based on state contracts.

Skills

Leadership

Communication

Cross-functional collaboration

Microsoft Office

Education

RN/LVN/LPN or other CA licensure

Tools

Microsoft Office

Job description

Molina Healthcare is seeking an experienced leader to oversee a multidisciplinary team delivering integrated care across care management, utilization management, LTSS, and behavioral health in California. The role requires CA licensure and extensive IPA delegation experience.

The position directs clinical programs, collaborates with senior leadership on strategic goals, and ensures adherence to regulatory requirements while maintaining cost-effective, quality member care.